Individual
LYDIA LOISELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4188
(860) 646-1222
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4188
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6926
CT
Other
Enumeration date
04/16/2025
Last updated
04/21/2025
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